Advances in pediatric asthma 2006

Because the outcomes experienced in adult asthma often result from pathophysiology that begins in early childhood, this year's summary focuses on recent advances in pediatric asthma. This past year, we have learned that early intervention with inhaled corticosteroids in childhood asthma reduces morbidity but does not alter the natural history of asthma. Theme issues over the last year focused attention on severe asthma and black box warnings. Both of these themes significantly affect the management of childhood asthma. Responsiveness to asthma treatment is heterogeneous even among patients with asthma of similar severity. This heterogeneity calls attention to the importance of assessing control and adjusting treatment accordingly. We are now moving toward an individualized approach to asthma therapy and searching for biomarkers and genetics as a resource to guide treatment. To improve asthma control, we must continue to obtain information on early asthma, severe asthma, asthma exacerbations, and methods to improve asthma control. Evaluation and management of severe asthma in children include verification of the diagnosis, assessment for coexisting illnesses, and identification of effective treatment strategies directed to adherence, medication delivery, and combination therapy. Application of biomarkers and genetics could be useful tools in individualizing our approach to the management of childhood asthma.